Mercer disease, often pronounced "MER-suh" for MRSA, refers to methicillin-resistant staphylococcus aureus. This nasty organism used to be acquired primarily in hospitals--in which case it was known as HA-MRSA, or hospital acquired MRSA--but in the 1990s a new strain emerged in communities. There have been reports of deaths in children with community-acquired, or CA-MRSA, pneumonia due to this new aggressive strain; in addition, it can cause a deep skin infection called necrotizing fasciitis.
Risk Factors
Approximately 25 to 30 percent of the population are colonized with the "staph" bacterium, which means the organism lives in the nose without causing infection; 1 percent of the population is colonized with MRSA, which is more difficult to treat, can cause life-threatening conditions like bloodstream infections and surgical site infections, and has a higher mortality rate
People at risk for HA-MRSA infections include the elderly, or others with weakened immune responses.
According to the Mayo Clinic, community acquired MRSA infections initially occurred in healthy persons without risk factors for acquiring MRSA and were isolated primarily from skin infections. MRSA is spread by contact. Initially children were involved, particularly those at daycare centers, but outbreaks soon developed in prisoners, soldiers and athletes who shared equipment or towels; intravenous drug users; those who get unsafely administered tattoos; Native Americans; and hurricane evacuees.
Symptoms
MRSA infections appear like ordinary staph infections and cause the following signs and symptoms: redness, swelling, warmth, fever and pain. MRSA can produce skin abscesses or boils.
Tattoos and MRSA
The risk of skin infections from tattoos is low. However, if the procedure is done without the use of sterile techniques, serious infections can occur. According to the Centers for Disease Control and Prevention, in 2004 and 2005 there were 44 reported cases of MRSA skin infections due to tattoos. Many of the infections were mild, but 16 required surgical treatment. Four patients developed bloodstream infections and needed IV antibiotics.
Diagnosis
The standard way to diagnose MRSA infection is by culture and sensitivity, which takes several days. In 2008, the federal Food and Drug Administration approved a rapid two-hour MRSA blood test (BD GeneOhm StaphSR Assay), which allows more effective diagnosis and faster treatment.
Treatment
Vancomycin used to be the drug of choice for HA-MRSA pneumonia, or bloodstream infections. Over the past 15 years, strains of MRSA have been isolated that are intermediately resistant to vancomycin (VISA), or resistant to vancomycin (VRSA).
ZYVOX (linezolid) is a newer agent that is highly active against MRSA and is approved for treatment of community-acquired and hospital pneumonia, as well as complicated skin infections, including diabetic foot infections.
CUBICIN (daptomycin for injection) is indicated for the following MRSA infections: complicated skin infections, bloodstream infections and right-sided endocarditis.
CA-MRSA strains remain sensitive to vancomycin, as well a wide variety of antimicrobials. In addition, abscesses may respond to incision and surgical drainage without the need for antibiotics.
Prevention/Solution
According to the Mayo Clinic, there are ways to prevent MRSA infection.
For health care workers, the best way is to wash their hands frequently, to disinfect hospital surfaces and to wear gowns and gloves when working with people infected with resistant bacteria.
If you participate in contact sports, do not share razors, towels or athletic equipment.
If you get a tattoo, only go to a licensed tattoo artist who uses sterile techniques. Also, keep the tattoo covered until the skin is healed.
